<form id="search-form" method="post" action="/find-a-doctor">
    <?php echo $form->renderHiddenFields(false) ?>
    <div class="inline-block">
        <ul id="1st-selections" style="<?php echo isset($marginLeft) ? $marginLeft : "" ?>">
            <li class="selection">
                <?php include_partial("common/search_select_field", array("form" => $form, "field" => "speciality_id")) ?>
            </li>
            <li class="selection">
                <?php include_partial("common/search_select_field", array("form" => $form, "field" => "region_id")) ?>
            </li>
        </ul>
    </div>
    <div class="inline-block">
        <ul id="2nd-selections" style="<?php echo isset($marginLeft) ? $marginLeft : "" ?>">
            <li class="selection">
                <?php include_partial("common/search_select_field", array("form" => $form, "field" => "city_id")) ?>
            </li>
            <li class="selection">
                <?php include_partial("common/search_select_field", array("form" => $form, "field" => "gender")) ?>
            </li>
        </ul>
    </div>
    <div class="inline-block">
        <ul id="3rd-selections">
            <li class="selection">
                <div class="doctor-custom-search">
                    <label for="doctor_name" class="label-visible">Enter doctor's or practice's name</label>
                    <input type="text" id="doctor_name" name="doctor[name]" autocomplete="off" class="prompt-text" title="Enter doctor's or practice's name" />
                </div>
            </li>
            <li class="selection" id="find-doctors-by-selection">
                <button class="blue-button-30" type="submit" id="find">Find</button>
            </li>
        </ul>
    </div>
</form>